Early Pregnancy Bleeding & HCG Levels: What to Expect

Question
Hi there,

My partner and I are currently in a state of utter despair. We found out about a month ago that we were going to have a baby. At 5 weeks my partner started bleeding - only mild spotting, but accompanied with slight pain. We called the doctor and then went for a scan and blood test. The scan showed nothing but since it was only 5 weeks at this npoint we also had a blood test. The hcg reading was 990 and we were told that it should double in 48 hours. The next test, two days later, showed a hcg of 1400. After anbother scan the doctor 'thought' she could see a sac but wasn't sure. We came back 2 days later again and a further hcg showed 1870. Another scan and a different doctor. He had trouble finding a sac as well and said that they felt, because of the hcg levels and the failure to confirm a sac, that it was an ectopic pregnancy. Yesterday they did a laparoscomy at the hospital but found nothing in either of the fallopian tubes. Since they can't find the sac they have now said that it will be treated as a miscarriage. They did one more blood test, which now shows that the levels are at 1700. The doctor said it seems like the pregnancy had stopped but they can't be sure since they can't locate the sac. We are now scheduled for another scan and hcg the day after tomorrow.

We haven't had a straight answer at all this week and no one at the hospital seems to be giving any clear answers. It's all "mights" and "maybes". We just wish someone could say exacly what the most probable outcome is. Could it still be ectopic that they just didn't locate? Or could there still be a viable pregnancy in the womb somewhere? Any help or advice would be so much appreciated, as we really are very scared now.

Thank you so much in advance for your help.

Answer
Dear Jn

It is really difficult to locate a sac at 5 weeks. However it may be possible with a transvaginal sonography, high quality sonographer and a machine with excellent resolution. If any of these is not available, a sac may not be visible at that age. I understand that your first doctor was able to locate a sac but no one was, in the next visit. At the same time, hCG level was rising, although it of minimal significance.

It is my opinion to have a second scan after a period of 1-2 weeks from the first scan. Result should be conclusive at that time.

I would appreciate it if you let me know how things went in a future mail.

Best wishes